Tag: mental health

This fall, many South Asians rejoiced as India’s highest court struck down Section 377, a colonial hangover of a law that criminalized homosexuality as punishable with up to 10 years of prison time. Delhi’s high court first pronounced the law unconstitutional in 2009, but this verdict was overridden four years later by the Supreme Court, who took up the matter again this year after receiving complaints. State-sponsored homophobia persists in other parts of South Asia, except for Nepal, where same-sex marriages have been legal since 2007.

Decriminalization, of course, doesn’t mitigate oppression, though many celebrated it as a start. In the wake of this international jubilation, the conversation about queerness and transness continues to evolve. Nation states aside, public attitudes might considered largely intolerant: a 2014 Pew Study found that 85 percent of Pakistanis and 67 percent of Indians thought homosexuality was morally unacceptable. How might we forge paths for future generations, especially as we reconstruct notions of South Asianness in the diaspora?

The implications of the multiple axes of oppressions that South Asian-origin people who identify along the LGBTQ spectrum face has been historically understudied; until recently, there may not have been a critical mass to study in the United States. Today, there are more than 4.3 million South Asians in the fastest-growing ethnicity box (“Asian”). As all study of intersectional oppression goes, academia’s tools may seem limited—or not expedient enough. For many young queer and trans South Asians, finding hope today is a priority—one that is threatened routinely by stigma.

“Stigma against mental health is rampant in many of our communities because we’ve often internalized these assimilationist logics wherein we’re often supposed to be some kind of ‘model minority,’ which becomes especially hard to battle if you don’t come from class privilege,” says V Varun Chaudhry, a PhD candidate at Northwestern University, who says they have consistently turned to black feminism, especially canonical voices like Audre Lorde’s, to make sense of power and self-love.

Queerness in the United States, for non-Black or -Indigenous minorities, is heavily informed by ethnicity and race.

“There’s a dual struggle for queer South Asians to find community. First is at home with family and extended family, and second is within LGBTQ+ spaces which are often white-dominant,” says Dom Chatterjee, founder of QTPoC Mental Health, a grassroots organization to create both online and offline spaces for queer and trans people of color. “There’s little representation for queer South Asian people, which for me meant I felt like I was bad at being queer and bad at being South Asian. QTPoC Mental Health gave me opportunities to meet other queer and gender non-conforming people of color and gain validation around that dual struggle.”

Chaudhry points out the space that desi people occupy in a global racial context. “Especially in ‘colonized’ or ‘western’ contexts, the positioning of ‘desi’ is always in relationship to antiblackness and white supremacy,” says Chaudhry, remarking on the struggle of the South Asian to make sense of where they fit as a racialized ‘other,’ who still has capacity for assimilation and class mobility. “So mental health often looks like unlearning both white supremacy and anti-blackness in order to accept ourselves, our bodies, and our experiences as enough, as whole, and as beautiful.”

More than organizations, people turn to peers, if the recent survey I conducted online and distributed by affinity groups and networks was anything to go by. The survey received 17 responses with participants ranging from 19-33 in age, most under 25. (The survey, which had nearly 200 visits, had an 11 percent completion rate. )

Eight out of 10 respondents said they sought support from friends and mental health providers over family, queer networks, or support groups.

“Mostly it’s been through community and friends, a handpicked chosen family,” says Tiara, a gender non-conforming femme. “I’m pretty used to not being represented anywhere and there’s nothing in the diaspora that really speaks to me on everything, I have to cobble it together from disparate sources. Some of the most supportive people have been the most different (e.g. cis white guys)—you can’t predict this, really.”

Leila, another participant, said that “seeking out older South Asians” has been very important to her in living her queerness in the diaspora. Other participants noted social media personalities like Alok V-Menon and Tanwi Islam in their responses.

Several respondents pointed to media, both social and otherwise, as being restorative—and transformative. “I could never articulate my queerness until college. It just dawned on me about a year and a half ago. Processing was just putting together pieces and realizing how much I refused to allow myself to be queer,” said queer-identified S, who said that Twitter really helped them. “People had been asking me my entire life. It was exhausting.”

AJ, a non-binary brown person, journals, pulls tarot, and prays, in addition to seeing a therapist through their school for diagnosed PTSD., but says they still find their queer identity difficult to navigate. “Gayatri Gopinath and Priyanka Meenakshi’s writing have been really helpful for me to conceptualize my queerness and gender,” says AJ. Gopinath is a professor at New York University whose book Impossible Desires: Queer Diasporas and South Asian Public Cultures is a staple in queer desi scholarship; Meenakshi is a writer-illustrator. “It’s something that grew out of so much sadness and confusion but has evolved into a source of liberation. People like to think that queer people are always happy and fun,” says AJ, for whom, being queer can feel lonely and difficult. “We forget that to be queer is to constantly be in survival mode and in resistance, but finding joy is incredibly important for me.”

Resilience is a word often invoked when speaking of sexual and gender minorities—it is a daily resistance to prejudice and discrimination. In a study of trans youths’ experience of resilience, researchers Anneliese A. Singh, Sarah E. Meng, and Anthony W. Hansen found that the ability to self‐define one’s gender, proactive agency, and access to supportive educational systems, connection to a trans-affirming community, reframing of mental health challenges, and navigation of relationships with family and friends were essential to building resilience. The researchers also identified six threats to resilience: experiences of adultism (the power adults have over children), health care access challenges, emotional and social isolation, employment discrimination, limited access to financial resources, and gender policing. Participants described “a very individualized process of learning to affirm their gender identity outside of prescribed (or routine) navigation of identity formation,” and the researchers recommended mental health practitioners “develop trans-affirming environments for their clients.”

Kripa, a 20-year-old cis lesbian, has found therapy, transparency, and mindfulness helpful in managing her depression. “I’ve been in therapy sessions where even though I knew my therapist wasn’t homophobic, I don’t know how much they understood that identifying as a lesbian affects my life?” she tells INTO. “I think a lot of them saw it as just another aspect of my identity as opposed to the identity that’s had the most social and personal costs to me?”

Vikasini, a young bisexual woman, worries that seeking medication would impact her employment. “My PCP prescribed me medication for depression but I was too nervous that a diagnosis would affect my work,” she says. “I am in medical school and my ‘superiors’ can see my medical record.”

A 2009 study of 94 LGBT-identifying South Asians in Southern California found that even if they had access to health services, cultural norms and the related threat of community alienation highly impacted the likelihood South Asians would seek help. “Many [LGBTQ] South Asians feel so alienated and isolated from the broader South Asian community, the broader [LGBTQ] community, and U.S. society in general, that any intervention targeting this population should address changing cultural norms in order to be effective and responsive,” wrote the researchers. Seventy-nine percent of respondents had access to mental health care, but only 30 percent availed of it.

South Asian queerness may be a particular one influenced by its own postcoloniality, with multiple respondents bringing up colonial pasts as a present-day issue. The criminalization of homosexuality in South Asia is, after all, a colonial relic.

To Shivani, being queer in the diaspora means “a return to pre-colonial lifestyle—not to romanticize Hindu-Brahmin dominated society—a return to my relationship with Hinduism and Indian culture before white people commodified it and made it feel inaccessible and exotic.”

The diaspora itself poses its own degree of friction, where many South Asians have raised families in more archetypically individualistic societies, where honor and fear of social contamination may be limited to friend circles rather than a looming, amorphous samaj.

Rashmi, a queer teenager, says that her queerness is a sort of reclamation. “It’s reclaiming an identity which is constantly erased and invalidated, and it’s a creation of a new existence which contains both American and South Asian influences of ethnicity and sexuality,” she tells INTO.

Colonial narratives have stripped South Asian culture of its queerness and inculcated homophobia, some contend, while others stress that the oppressions these societies also enact cannot be ignored. Within the umbrella term “South Asian”—a term used to build socio-political solidarity in the diaspora, when in the subcontinent inter-nation conflict abounds—there exists layered oppressions, especially caste-, class-, and religion-based, and being away from the homeland hasn’t solved it. According to a 2017 Equality Labs report, one in four Dalits reported experiencing physical violence because of their caste—and four in 10 reported being rejected romantically because of it.

A study of Black and South Asian gay men in Britain found that for South Asian men, a “major theme was regret at being unable to fulfill family expectations regarding marriage and children.” This family-specific anxiety is one that may be common across the board for those identifying as queer and trans in the South Asian diaspora.

“Sometimes, the behavior of one family member in South Asian communities might be considered representative of the family as a whole to the rest of society. This can cause individuals to have higher levels of guilt for even having thoughts related to being LGBTQ,” says Dr. Neeral Sheth, Assistant Professor of Psychiatry at Rush University Medical Center in Chicago, IL. “Some individuals may feel that having someone with am LGBTQ identity in the family could even impact the marriage prospects of siblings, if the family is going down the route of an arranged or semi-arranged marriage.” When the prospect of even an inter-racial or -religious relationship may threaten the family’s concept of honor, queerness and transness pose an even larger issue.

In Dr. Sheth’s experience, South Asians, especially when parents are 1st generation immigrants, “tend to place an importance on respect and obedience to parental figures.” Some may fight their LGBTQ identities because they do not want to disrespect their parents, says Dr. Sheth.

“This ‘disrespect’ can not only change family dynamics, but also impact the financial stability of younger South Asians still dependent on their parents,” Dr. Sheth says. Researchers have studied younger South Asians’ resistance to cultural deviancy, especially in dating and sexuality, finding answers in a social bond theory, though this study did not explicitly cover queer and trans dating.

“Acculturation and enculturation are both processes of change an individual undergoes when they move to a new culture; this can cause tension within the family as well. Something I hear frequently is parents initially blaming ‘American culture’ for their child identifying as LGBTQ,” says Dr. Sheth, who adds that family members of queer and trans individuals may place blame on themselves and experience negative psychological symptoms because of it.

Youth from more conservative and anti-queer cultures may resort to more existential thinking such as “Why did God make me gay?” finds Dr. Sheth.

“This obviously has a huge impact on the child/adolescent’s identity formation. LGBTQ adolescents might delay life experiences/social development in order to feign being cisgender or heterosexual,” he says. “They might have their ‘firsts’ at a later age and might be behind their peers in terms of these important life events.” Young Asian Americans tend to exhibit more sexually conservative attitudes and behavior, research finds.

Dr. Sheth points to stigma as being a major issue in this population, noting that in anticipating future prejudice or discrimination, individuals may have higher levels of baseline stress.

“There is not only the stigma of being brown and the stigma of being queer, but unfortunately a lot of people may feel stigmatized for accessing mental health care as well,” he says. “Many feel uncomfortable with the vulnerability of asking for mental health support. Although there are great efforts being made to reduce this stigma in the general population, I think South Asian communities often still consider mental health issues a weakness or moral failing.”

Queer and trans South Asians find themselves minoritized multiple times over. Racism and xenophobia are not limited to the mainstream, with the LGBTQ community also demonstrating similar forms of exclusion. Of course, as Dr. Sheth points out, people within the South Asian community may internalize racism, homophobia, and transphobia to cope with their own sets of isolation.

“This can be very isolating as it can sometimes be difficult for individuals to find an ‘ingroup,’” he says.

Dom Chatterjee, editor of Rest For Resistance, notes that community support is essential to identity production, a process that can be harmed by isolation and ostracization. “And more specifically, meeting other queer South Asians—who are all uniquely beautiful in how they embody their identities—helped me see that I’m not bad at being queer or South Asian, but that our identities and potential have been masked and can be uncovered and honored through collective effort,” Chatterjee says.

Participants in the survey described their family’s understanding of LGBTQ matters in a variety of ways: “problematic,” “tolerant, but not accepting,” “supportive, sometimes apathetic,” “it’s fine if nobody knows,” “accepting in the form of erasure, minimizing, and neglect,” and “only one gay cousin per family, right?” Kripa recalls how their family found out about their queerness through Twitter.

“This was followed by an awful couple of days of them questioning and berating me,” they said. “We haven’t talked about it since. I think someday we will have to be transparent about who I am and the harm that has transpired, but I don’t know when that will be.”

Dr. Sheth also points out that some in the South Asian community think of queerness and transness themselves as representations of mental illness. “This belief can cause queer people to avoid accessing care because they feel they are perpetrating this belief by acknowledging they need mental health support,” he says. “There is evidence that LGBTQ people do have higher rates of depression, anxiety, substance use, suicidality, and other mental health concerns—this is due to the effects of stigma, though, and not something that is inherently part of being LGBTQ. It is well theorized by the minority stress theory (Meyers, 2003).”

The dissimilarity of queerness to the model minority archetype possibly contributes to the fear of social contamination the South Asian community might have towards people who are LGBTQ.

“Deviancy from the prescribed norms of what it means to be a successful person in South Asian communities tend to be fodder to such treatment,” says Hima Sathian, who works with minoritized populations in New Jersey, of the conflation of queerness with mental health issues. “There’s a lot of fear there, of being unable to imagine what a life that does not include following one’s assigned gender script, marrying another of the ‘opposite’ gender, and then having biological children could entail. There are other factors that drive these mechanisms too like patriarchy and casteism…essentially, about how maintaining these power structures are a bigger priority than it is preserving people’s well-being, love, and joy.”

Hima, who is in a relationship with another queer South Asian, says they “try our best to face the reality of our histories, our family’s histories, but do so with as much compassion to ourselves and our families as we can.”

The burden of speaking up is also disproportionate. As Erving Goffman notes in his 1963 work Stigma: Notes On The Management Of A Spoiled Identity, “the more there is about the individual that deviates in an undesirable direction from what might have been expected to be true of [them], the more [they are] obliged to volunteer information about [themselves], even though the cost to [them] of candor may have increased proportionally.”

Vikasini recently came out to her parents. She believes they consider her homosexuality a “phase” and a reaction to early childhood sexual trauma she had. But to Vikasini, her queerness in the diaspora “means layers of hidden desire and longing which can’t permeate and become a part of my visible identity because my roles as a daughter, future doctor, and Indian community member outweigh my right to outwardly bear my inner truth as a queer woman.”

Images via Getty

This article was made possible by a grant from the American Society of Journalists and Authors

Honestly, all bodies, especially mine seemed haunted and my desires scared and perplexed me throughout my adolescence. Like I was straight up frightened. Like we traced the call and it’s coming from inside your body spooked.

When I was in middle school, I became convinced that I was possessed by some sort of malevolent creature from another realm. I cycled through all the possible demons and spirits who might have been making a home out of my body. I would pour over books on mythology and religious iconography in my suburban Texas town’s Round Rock Public Library on Main Street attempting to diagnose and identify the unwelcome squatter. This particular train of inquiry only lasted a short while but my body and what it wanted would continue to confuse me well into adulthood.

My issues with sex weren’t for lack of interest—trust me, I was obsessed with the concept but the whole to-do of it all disarmed me. Later in life, when I would try to submit myself to a sexual partner, my body would get all finicky and uncooperative like a water hose left to long with a kink in it. Nothing would work right. Every permutation of sex felt somehow wrong and impossible.

No one I knew had been able to teach me anything about the kind of sex I wanted to have—in fact, any and all information on gay sex had seemingly been erased from all of the books where I grew up. Little southern towns have a way of maintaining the whole extended moratorium on sodomy and all. I remember cherishing any sort of subversive media I could get my hands on. At 14, I thought XY Magazine was a radical piece of homosexual propaganda and I was shocked that it was available in my local Hasting’s. When I was finally able to dial up download pornographic photos, I stored them on floppy discs (six or seven low res photos fit on each) and hid them in a KNEX box at the bottom of my closet with a pack of cigarettes and some old coins that my grandfather had given me.

When I first came out, I included a lot of caveats to my new identity. I swore up and down that I would never engage in penetrative sex on either end of the equation. I was going to keep it “Christian.” You know, like Jesus and the apostles. Lot’s of mouth stuff but, you know, they were just friends. It was super important for me to place my gayness as close as possible to the heteronormative ideal as I could. I pulled that whole “I’m gay, but, like, that doesn’t have to define me” schtick.

In my twenties, I had boyfriends and I explored sex more but every time it came to my body, to my penetration, I would lock up again. My defenses still engaged, I was unable to submit or participate. My brain, or at least part of it, was game but another part of me refused. Deep inside of me it felt like something angry was lurking.

Supportive people have told me that there is no such thing as a being “bad at sex” there’s only “bad sex” or “incompatible sexual partners” and intellectually I think I always understood that. But emotionally I truly felt as though I was the exception. Something was wrong with me. Something was broken inside of me. Even after I came out I was sure that some part of me was rotten. My body felt haunted, unsafe, and inhospitable, like an old house full of Shirley Jackson spirits. I gave up. I put up a sign: DO NOT ENTER. My body was structurally unsound and prone to collapse. Abandon all hope ye who etc., etc. From a very early age, I felt condemned.

During this period of my life, I used to break into an old abandoned cotton mill in Walburg, Texas with my friends. The mill was straight out of a horror movie—literally portions of it were used as a filming location for the 2003 remake of The Texas Chainsaw Massacre. I’m not sure what happened to the mill that resulted in it shutting its doors and falling to rot, or why it was never torn down after all these years, but I suppose there is a story buried there. Something about small towns, money, and lost jobs.

This was during my “I’m not gay, I’m struggling with my sexuality” phase. We can translate that to “I still hook up with guys but then I cry and pray about it afterward.” I had already come out once when I was 15 but I sort of lost the thread of that identity when I started hooking up with older men that I met in AOL Chat Rooms. I wouldn’t have “sex” with them but that wasn’t because they didn’t try. I became an expert at the dodge and weave, always offering an alternative, until one day I got too scared. A man drove me too far from my home on a road I didn’t recognize and suddenly my mortality was very real. I put myself back in the closet, joined a youth church, and got super religious. I wouldn’t even attempt to have penetrative sex until I was 22 years old.

I was 19 at the time, living in Austin, and performing with a Christian screamo band then called The Kirby (later called Widows & Orphans… it’s still on Spotify). It was a whole moment. Think 2005. Think Chi Flatirons caked in hair product. Think Lucky Strike Cigarettes, lip rings, and women’s jeans. I’m sure the era is conjuring some cringe-worthy images in your mind and I would recommend you just apply them all. We were very invested in the contrived but earnest efforts we were making to define ourselves. I saw something in all of this posturing that I wanted.

I had joined The Kirby because I was functionally in love with one of the members of the band. In case you were wondering what to do if you have a crush on someone: DO NOT inexorably bind your life with that person for four years in hopes that they might eventually fall in love with you. They won’t. I did all sorts of stupid unhealthy things while nursing this taboo crush. Drank to excess, drove unsafely. I dated a few very kind and understanding women while knowing deep down that I wasn’t available in the way they were hoping. It was all dumb and unhealthy and very much standard for a closeted queer in their early twenties.

It was with these friends that I first broke into the abandoned cotton mill in Walburg. The mill was a massive rusting two-story building with overgrown bushes and tall yellow grass surrounding it on all sides and blocking the facade from view. Inside there was a central unit of “cotton machinery” that took up most of the interior space with a wrought iron maintenance catwalk surrounding the upper portion of the mass. The truss supporting the roof was failing and that loss of structural support had caused a cave-in on the south side of the building. This place was not safe to be wandering around in at night or any time of day but that made it way more exciting to explore. It was also a veritable spooky sound studio complete with clinking chains, moaning sheet metal, and dripping pipes.

Below the main machine unit, there was a stone stairwell that went down to a service basement where during our first visit to the mill we discovered a torn and soiled mattress. We were surprisingly undeterred even though possibly bloody mattress is maybe #1 on the list of murderer-nearby red flags. We would come back to the mill often sporting flashlights and Lonestar Beer (in my opinion the best of the cheap beers) and just hang around. We had discovered our own shabby chic condemned clubhouse.

One night, the guitar player and I went to the cotton mill in Walburg alone. Just the two of us with our flashlights and Lonestar. It was a date. It wasn’t a date but it had all of the trappings of a date. Or at least it was the closest I had experienced to a date in my life up to that point. We had returned to the mill many times over the years with more people without incident but on this particular mill trip, when it was just the two of us, something happened.

We parked our car to the left of the building behind some overgrown grass where we knew it couldn’t be seen from the road. The guitar player and I walked up to the loading drive with our flashlights off to further hide our presence. We had never been caught sneaking into the mill before and we liked to believe that was because of our expert espionage skills. I set our standard issue six-pack of tallboys and my flashlight on the chest-high cement loading dock and hoisted myself up. We had been here enough times that we had a comfortable understanding of the layout of the mill without much light. The huge metal doors of the loading dock were rusted and covered in tags and vaguely religious graffiti. One piece I remember in particular featured the words “seven lives were washed in the blood of the lamb” and seven crudely scrawled white crosses. Standard murder mill stuff.

As we entered the mill we heard a noise. It wasn’t the clink of the chains or the wind that rustled the leaves on the tree limbs that had grown into the building through the hole in the roof. The sound was new and unnatural. It was a guttural and foreboding hiss that grew into a growl. And the sound got louder when we shined our flashlights near the maintenance crawl space. Yeah, the same space where we once had found a dirty torn mattress. Being the dumb drunk young men that we were, we decided to investigate further.

As we got closer the sound intensified. We stepped through the threshold of a large wrought iron gate that separated the front section of the mill from the more mechanical rear and then suddenly something huge rose up out the ground with a flurry of darkness and motion.

The nightmare creature landed on the iron grating around the machinery with a metallic thud and bellowed a blood-curdling screech at us with its wings wide and imposing. It ran at us flapping it’s massive five and a half foot wings, the sound of its talons clanging against the hard rusting floor, it’s howl reverberating off the metal structure around us. We screamed and scrambled together back behind the iron gate we had passed through and slammed it closed just as the demon flew up to face height to rip our eyes out. We fell to the ground and held the gate closed with our feet as the monster attacked. Eventually, after what seemed like an hour but probably only amounted to a minute or two, the beast flew up through the hole in the roof and we were left dirty, breathless, and bruised on the ground. We had just encountered an angry Black Vulture. We had disturbed its nest in the middle of the night.

I found myself thinking about this vulture a lot. It’s screeching would come to mind when I thought of the guitar player and the one time we did finally kiss in a hotel room, the time when I knew he was just trying it because I had asked, just because he cared about me. Not in the way I was hoping. I would think about this vulture when I would try to have sex with future partners, when I would feel something angry and defensive rising up inside of me.

I would think about those men, too. The men who I used to meet in AOL chat rooms. The men who I had to repeatedly tell my boundaries to, even as I was just learning what boundaries were, the men who I would offer alternatives hoping that it would be enough to make them feel good, to make me feel real, to give my body value.

That vulture was just protecting it’s home. It had nested in that decaying mill and it felt responsible for keeping away predators. It had no way of knowing what we intended to do, what kind of danger we posed, it just knew that it was scared that we wanted to take something away, it was afraid that we wanted to kill something that couldn’t be brought back. I lived with this vulture inside the condemned wreck of my body for years, I convinced myself that it would always be there, screaming, refusing to let anyone enter.

Until one day it was gone. OK, fine. That’s not true. That sort of oversimplification is a disservice to the truth. The real answer, the longer answer, the “Did this movie really need to be over two hours long?” answer is this: I spent well over a decade learning to trust people with my body and I still struggle with it often. Too many men had tried to use me at too young an age and no one had been able to teach me how to have a queer body in the first place.

Learning to let my guard down involved dozens upon dozens of attempts and a lot of disappointment. The first thing I had to understand was that I wouldn’t break when someone was inside me. Despite all of my fears of the dismantled and decrypted interior structure of my body I actually share little in common with the old forgotten mill I explored in my youth. I was just nervous and I hadn’t had an opportunity to feel strong yet.

Then it was a matter of finding sexual partners who knew how to read someone’s body. I feel like pornography has convinced generations of men that every body is ready and waiting for them to dive into and that is entirely and unequivocally not the case. I was lowkey traumatized despite talking a big game and that needed to be taken into account when trying to engage in sexual activity. Sometimes during sex I would feel myself getting scared, angry, and defensive. Some sort of baggage from the fight or flight response was lingering in my subconscious. A large vulture if you will. Sometimes during sex I would suddenly need to stop everything and relax. Sometimes I continued even though I felt tears boiling behind my eyes. Despite often feeling hopeless, I would always come back for another round of experimentation and finally, at the age of 30, I was more or less fully able to let my guard down.

I know now that I was never condemned, I was just in an extended state of being remodeled. My body, or more importantly my mind is in a good state now, though I’m still planning future refurbishments. The vulture has since retired and spends most of its time traveling. It still shows up every once in a while to water the plants but usually it’s out on a Royal Caribbean cruise or backpacking through Europe. Maybe the metaphor is dissolving.

What I mean to say is that vulture lived inside me for a reason but over time and with support from good folks those reasons changed. It took me a long time to feel like my body was mine again after a lifetime of feeling unstable, unsafe, and afraid. I kept trying and eventually, I found a power in my body that I never knew I had before. I discovered just how sturdy I am.

The vulture has moved on. My body isn’t a haunted mill. It never really was. It’s a cute brownstone with good bones. To be real with you, it’s actually kind of fancy.

When Nessi Hunter Alice was 13, they started experiencing nausea every time they ate, sometimes even to the point of throwing up. Nobody took Alice seriously, though, because they’re a non-binary person who was assigned female at birth. Health care providers wrote Alice off as hysterical.

“I went to an older male doctor for a while for that and other concerns,” Alice tells INTO, “and he basically refused to treat me for anything because I was delusional and he didn’t want to treat me until I got psychological stuff worked out. And he called me delusional partially because I identified myself as non-binary.”

It wasn’t until Alice found a doctor who was non-binary supportive that Alice was diagnosed with gastroesophageal reflux disease (GERD), which is when stomach acid gets into the esophagus, and got the treatment they needed.

Sadly, Alice’s experience is not an anomaly. “Jasper” (who prefers to be anonymous) tells INTO that they went into a psychologist’s office for a disability evaluation, but left the appointment in tears when the psychologist refused to use their pronouns and asked invasive questions about Jasper’s genitals. Others have health care providers that say they’re supportive, but their actions show otherwise. Jay, for example, was misgendered by their doctor in two referral letters to a gender identity clinic.

“I wish someone would hold doctors accountable for learning how to handle trans and non-binary folks on their own time without grilling patients for all we know and treating us like lab rats,” Jasper says, “asking irrelevant and frankly humiliating questions.”

A recent study published in LGBT Health broke down non-binary people’s negative experiences with health care providers into four categories. Some non-binary people experienced health care providers that had a very strict binarist view of gender. One named Vera, an indigenous two-spirit person, reported quitting their medical care because their provider kept assuming Vera wanted bottom surgery. Some reported difficulty finding health care providers who knew what non-binary meant, while others said they had to identify as binary trans people in order to receive proper medical care. Even some trans-friendly providers lacked knowledge about specific needs non-binary people have.

“It’s interesting because there’s a layer of folks who are going out and seeking care and either be actively discriminated against or not getting the best care possible because their providers don’t know how to offer it,” HRC Children, Youth and Families Program Coordinator Sula Malina tells INTO. “Then there’s the other layer of folks who simply don’t care to try anymore because they probably had terrible experiences in the past or they’ve heard terrible stories. So I think there’s a lot of missed opportunity in terms of affirmatively and even just correctly serving folks who really need it.”

“I just had some kind of negative experiences with my own health care as a non-binary person,” Malina tells INTO, “so I proposed we have a lot of documents and publications that deal with navigating being a frontline staff person and what do you do when somebody who’s trans comes in, or really what do you do when anybody comes in because anybody could be trans. But I don’t think that we have anything yet speaking specifically to the need for non-binary folks and the simple ways that providers and frontline staff can adjust to create space for folks with identities beyond the binary.”

Malina says they didn’t have a lot of negative experiences with health care providers themselves, but the few negative experiences they did have left Malina in tears. When Malina went in for top surgery consultation, for example, a health care provider didn’t take them seriously because they’re non-binary. Malina also had negative experiences seeking treatment for an eating disorder, which they say was closely connected to their gender dysphoria.

“There wasn’t an acknowledgment of the ways in which my eating disorder and my body image interacted with gender dysphoria and the ways that I was using the eating disorder as a way to control the transition in an unhealthy way,” Malina tells INTO. “Because there wasn’t an acknowledgment of that, I was just immediately, completely resistant to the idea of being helped by this provider.”

So what are ways health care providers can better serve non-binary patients? One example Malina gives is more inclusive intake forms that ask for a patient’s preferred name and pronouns.

“Of course, there’s still times when your legal name still needs to be used for insurance purposes,” they tell INTO. “But there are really quite simple ways to navigate that even with a kind of restrictive data system, which I know that folks are working with those data systems to just make those more inclusive as well and create more fields and spaces for preferred name and pronouns and things like that.”

Other tips include gender-neutral restrooms, avoiding gendered language until a patient’s preferred pronouns are known, using the terminology trans and non-binary patients use for their body parts and being aware of certain issues–like eating disorders and self-harm–that disproportionately affect trans and non-binary people. The main thing Malina wants health care providers to know is that providers don’t need to know all the LGBTQ terminology; just the simple act of listening to patients can have a tremendously positive effect.

“Of course there’s an important foundation of knowledge to have,” Malina tells INTO. “You should know what LGBTQ stands for. You should know the definitions of a few gender identities. But the reality is those definitions are only an approximation of an experience. Everybody who uses those terms to describe themselves around gender identity have a completely different experience of it. So I think the most important thing that a provider could have in that way is humility and, a knowledge of how to respectfully ask somebody what their experience is when it is necessary.”

In the mid-1980s, my late Aunt Sharon came out as a lesbian. She had just finished law school, a setting that embraced her “lifestyle,” and was deposited into a world where queerness and family aren’t easily bridged. Unprompted and unsolicited, she blurted out her identity to my grandfather, as my grandmother and Aunt Colleen stood watch.

My grandfather stared at her, confused but not angry, at the head of the kitchen table wearing boxer shorts and a dirty tee. He was silent and stony for some time while she pouted, awaiting his analysis.

“That doesn’t explain why you don’t have a job.”

His tone was sharp, flat, with a tilt at the end. Ajob. The two words were little barbs he poked into her, telling her that he could give a shit about her sexuality: he just wanted to know why she’s unemployed despite both an undergraduate and law degree. Why does a job matter? Aunt Sharon must have thought through fat sobs. Do I not matter?

We still laugh at this story. My family gets together and we laugh and laugh and laugh about how Aunt Sharon’s coming out to grandpa was overshadowed by her unemployment.

I learned the lesson from this story quickly. As Aunt Sharon’s queer nephew, I came out as gay in 2007 — and I wanted to avoid the laughs. It took me two years and perhaps a lifetime of thinking to prepare myself. I moved to Los Angeles after college and, two years after select friends and family knowing about “it,” it was time to let my parents know. There were hurdles: I needed a stable job, stable transportation, stable housing, and stable control of student loan debt. With young life’s landmarks wrangled, I was well equipped to tell my parents that, yes, I am a functional adult – and I’m a big fucking queer.

My coming out was ultimately underwhelming: I had made myself too presentable —successful, even — in the eyes of my Catholic, Georgia based parents, to my military father and my Puerto Rican mother. A near decade after my coming out, the searing laughter at Aunt Sharon lingers still as my younger sister, Mickey Fitzpatrick, must confront this adorable family issue with her own coming out.

“Do you think telling mom and dad at Thanksgiving is a bad idea?” she asked me by text a few months ago.

“I don’t think it’s an awful idea,” I texted back, hesitant only because of potential familial confrontations. A job rang through intergenerational lifelines, nuzzled between words.

She’s in a liminal — albeit secure — phase of her life. She recently began a sociology doctoral program at a southern research institute after completing undergraduate studies. She’s an overeager, overachieving student who lives a queer life away from our parents. Still, like me, she doesn’t know how to approach sharing her identity: she doesn’t want the instability of young adulthood to cloud her queerness.

“If this goes south, I have to make sure I’m already financially stable and not dependent,” she tells me, emphasizing that she can’t depend on someone whose view of you can easily shift. Her negotiation is tangled at the intersection of familial understandings of the world: she is the only daughter in our family of six, one framed by Hispanic, Catholic, southern, and military cultures. It’s complicated.

“I feel a sense of internalized homophobia for myself because of the way that mom attempted to really femme me up,” Mickey says. “There are a lot of checkpoints that she wants me to hit that I know I’m not going to. With dad, it’s a whole different ball game…His reaction makes me nervous because of his ties to the military and the Republican party.”

The blocks that Mickey and I (and even Aunt Sharon) face aren’t new, and they affect the greater queer community: these are matters of respectability, that you can live a queer life but you can only do so within society’s understanding of life at large. Socioeconomics and ethnocultural understandings of behavior are to blame, as are gendered roles and “traditional” life benchmarks. This problem occasionally trends in queer media, as Queer Eye’s Tan France’s family were only proud of him after watching the show while drag queen Monét X Change’s mother’s acceptance of their lifestyle was tied to Drag Race’s popularity. As Eileen Myles wrote in “An American Poem,” “I’ll be a poet.” They then reveal what lies beneath such a thought: “What could be more foolish and obscure. I became a lesbian.”

Yuvraj Joshi, human rights lawyer and doctoral scholar at Yale Law School, has been interested in this phenomena for years. “I think of respectability in contrast to respect,” Joshi explains, noting respect as an “acceptance of difference” while respectability “suggests acceptance of the norm.” The matter places the pressure on others ceasing their “unacceptable difference” instead of blanketing acceptance toward another approach to life, to alternative ways of living and thriving.

The trickle down of respectability is much more than Aunt Sharon getting a job, but alters human rights and recognition of queer persons. “Even where legal recognition has been afforded to same-sex relationships, it has tended to center on their normalcy rather than their diversity and inherent worth,” Joshi says. The 2015 marriage equality ruling in Obergefell v. Hodges is a great example of this: instead of changing or adapting what marriage means, same-sex couples were instead slid into a heterosexual norm to illustrate that they, too, are worthy. “Put another way,” Joshi explains, “Respectability — not respect — underpinned the legal right to marriage equality.”

As my family is evidence of, the weight of respect comes with an assortment of internalized problems: Joshi points to shame, conspicuous consumption, and conformity as a few byproducts of being respectable. Yet, as Mickey and I discussed, the fact that we’re able to have such a conversation represents luxuries and privileges we have been afforded. “Benefiting from respectability entails drawing on existing economic, social, and cultural capital that is accessible to relatively few queers,” Joshi says. “Respectability is measured by proximity to white, male, middle-class heterosexuality, and not everyone is able or willing to fit the mold.”

Whether intentional or not, I have put myself up to a mold that was given to Aunt Sharon by my grandfather as the marker of my own queer acceptance. This, in some ways, has been a driver to leap over common benchmarks, to be as successful as possible in order to still be seen as part of the family or worthy. My sister – who is pursuing a doctorate in sociology – and my Aunt – who had a law degree – participate in bowing to the pressure too. You could call it an accidental form of queer excellence.

D’Lane Compton, Associate Professor of Sociology at the University of New Orleans, sees this behavior as a queer norm. Compton suggests queer persons’ over-education – 46 percent of lesbian and gay individuals and 33 percent of bisexuals have college degrees – as proof of our inclination to overcompensate. “That’s a huge statistical difference,” Compton says. “It’s actually a remarkable difference.” Similarly, gay people typically make more money than their straight peers. While an explanation for this remains elusive (Higher education? Lack of children? Whiteness?), the fact persists.

This may relate to a queer intelligence at play, of juggling different, intertwined identities in order to be deemed worthy. “At every turn, we’re going to be ostracized or have to deal with microaggressions,” Compton says. This all informs very complicated queer self-concepts which are the manifestations of our own mental intersections. “We have these ideas of who we are but we have this single self-concept of who we are and they all affect one another,” Compton explains. “Our different identities intertwine.”

While Millennials wrestle with prioritizing selves to be respectable, this issue may minimize under the heels of our increasinglyqueer next wave of adults, Gen Z. “They’re working within the system to change the system,” Compton explains, reflecting on their experience with queer students, which stands in contrast to Millennial queers looking for loopholes or working around respectability problems.

Compton theorizes that younger queer persons are dismantling respectability by reconstructing the map to success, a quality that many queers at large participate in. We seek peers and public figures who have thrived despite adversity in order to thrive ourselves. It’s the “power of the role model and visibility,” of queer and non-queer minority figures overcoming barriers, that is yielding change. “That’s where we’ve taken our map from,” Compton says. “We’re piecemealing this together depending on our resources.

For now – for my family, for my sister, Mickey – this future may appear far away, as if the workload of acceptance only gets heavier with each reveal of the self, given the initial jab at Aunt Sharon. Are we all jokes to them or will they eventually see us completely? “It’s not the duty of the marginalized to educate the oppressor,” Mickey says. “But, in instances like this, you can’t kind of just do whatever you want or be whoever you want to be…What experiences can I share with someone who is holding me to their standards so they can understand my humanity instead of my merit?”

“Regardless of what I accomplish in my life, I am still a person – and still deserve respect regardless of my job, ability to pay my bills, my sexuality,” Mickey says. “I’m still a person and I deserve respect.”

Perhaps this is the part of the story that we’ve forgotten to tell in my family: maybe Aunt Sharon spat back at her father – my grandfather, the Fitzpatrick patriarch – to say that her worth isn’t predicated on a paycheck. Yes, that may help a man like my grandfather and people like my parents understand a queer person better – but our lives and our paths and our ways of living are not the same. This needs to be recognized.

Perhaps this was why Aunt Sharon sobbed at the barb that we still laugh at. Perhaps she knew that, one day, people like her would redefine the definitions that sought to steal her power. She happened to be too early for respect.

This #WorldMentalHealthDay, I posted a social media status about how imperative it is for folks from minoritized communities to support therapists from underrepresented backgrounds – counselors and psychologists who identify as people of color; queer, trans or non-Christian folks; and/or as individuals who have mental illness or other disabilities. Suddenly, I received 12 inbox messages from Facebook friends, all of them inquiring about how to find a therapist. If this doesn’t speak to underrepresentation in the field, I don’t know what does.

Unfortunately, little has changed during the 40 or 50 years since the mental health field first opened its doors and ivory towers to folks besides white men – starting with middle and upper-class white women. A number of professionals in the mental health field, much like many educators in the field, believe that clients from minoritized communities gain no exceptional benefits from working with therapists who share with them a certain identity and community.

Today, more than any other demographic, white women still dominate the field, constituting upward of 75 percent of therapists and social workers. Correspondingly, a 2013 study found that White Americans comprised 83.6 percent of psychologists, while the representation of Black Americans stood at 5.3 percent, Latinx at 5 percent, and Asian Americans, a mere 4.3 percent. Native Americans were not even accounted for.

I’ve also found no estimates, to date, of the number of LGBTQ therapists, which means that queer, Black therapists like me are essentially erased and invisible. This poses a huge risk for the millions of queer people of color out there, who desperately want and/or need to know if therapists like me even exist.

A number of professionals in the mental health field, much like many educators in the field, believe that clients from minoritized communities gain no exceptional benefits from working with therapists who share with them a certain identity and community. Yet, research on race-matching suggests that for some clients, sharing a minoritized identity with a therapist may reduce guardedness, mistrust, and self-consciousness. The converse idea – that representation is only surface-deep – isn’t backed by any evidence, and is quite frankly rooted in greed.

People deserve to have their needs met. Simple as that. So, my professional ethics and integrity mean that I never let clients settle for a therapist who isn’t a good fit, including myself, possibly.

Still, I felt compelled to raise awareness about the overlooked issue of minority therapists needing support. Institutionalized bias often drives us into private practice, but we also experience discrimination in the competitive race of the Psychology Today job market. Oftentimes, without any reciprocity from the communities we aim to serve and advocate for, we can’t get our businesses off the ground or claim our stake in the field. Moreover, when our communities don’t know how and where to find us, the potentially mutual benefit that could happen, can’t happen.

Enter: this directory of directories.

Please feel free to share this resource guide with others who may need it. I hope that it answers the many questions that I’ve received. For more culturally relevant information on how to navigate the mental health system and tips on how to find a therapist, you can check out “Therapists for Women of Color and Queer People: How to Find One,” follow me on Twitter @Fight4TheYouth, or visit my website, jeffbaker.org.

* In the Psychology Today directory, you’ll see that therapists of diverse backgrounds may appear in search results, even after filtering for specific cultural groups. That’s because the system lists cultural groups as skills, not the identity of therapists. Use discretion, but don’t lose morale. The Psychology Today directory is arguably the most cohesive and robust therapist directory. You’re able to filter by counseling issues, cultural issues, psychological disorders, and even insurance plans and virtual therapy providers; and you’ll also be able to view each therapist’s credentials, and sometimes even their fees.

According to the 2015 U.S. Transgender Survey, 40 percent of trans people have attempted suicide at some point during their lives, and 48 percent have seriously considered it. A more recent report from the American Academy of Pediatrics confirms this high risk even among transgender adolescents. Nearly half of adolescent trans guys reported having at least one suicide attempt in their lives, with more than 40 percent of non-binary adolescents and about 30 percent of trans girls reporting the same thing.

What’s interesting to note is how much trans boys are at a great risk of suicide — higher than trans girls and non-binary adolescents — but the study doesn’t explain why. Are there unique obstacles young trans men face that other trans-identified people don’t?

Perhaps surprisingly the answer is yes. “I think one of the obvious risk factors that trans men experience is sexual assault and violence,” says trans blogger Sam Dylan Finch of Let’s Queer Things Up. “Not that we don’t see this happening to folks of other genders, but people perceived as girls and women have a categorical risk for sexual violence that makes them vulnerable early on in life.”

Add racism to the mix and it’s worse. The 2015 US Transgender Survey revealed that 51 percent of trans men, 58 percent of AFAB non-binary people and 37 percent of trans women have been sexually assaulted. The survey breaks it down even more and reveals that Indigenous trans men are more likely to be sexually assaulted at 71 percent, followed by Middle Eastern trans men at 67 percent, multiracial at 58 percent, and white at 52 percent. “Patriarchy, generally, has a profound impact on anyone who is assigned female at birth, regardless of how they identify later in life,” Finch says.

Dr. Elizabeth Saewyc, Executive Director of the Vancouver-based Stigma and Resilience Among Vulnerable Youth Centre (SARAVYC), not only noticed the increased odds of suicide attempts among trans men of color, but also bisexual and pansexual trans men. Several past studies have revealed higher rates of suicidality and poor mental health among bi+ people than gays and lesbians. This is because bi+ people not only experience bigotry from straight people, but also from gays and lesbians. Researcher Tangela S. Roberts told the Daily Beast in 2016 that the bigotry coming from heterosexuals is only “a decibel higher” than biphobia from gays and lesbians.

“This study [from the American Academy of Pediatrics] was one of the first I’ve seen that was large enough,” Saewyc says, “and diverse enough, to actually look at intersections of gender identity and sexual orientation and ethnic diversity, while at the same time accounting for geographic location, and other social locations.” The result is more evidence of how intersecting identities impact different people in different ways, and how various forms of oppression interlock with each other.

So what can be done about it? “We need mental health professionals to commit to educating themselves about the unique issues and needs of trans men, which means first, reading the research out there, but even more importantly, listening to trans men about their experiences, and what will help support them in their lives,” Saewyc says.

She also says LGBTQ organizations need to recognize how interwoven systems of oppression impact LGBTQ people in different ways. “Clearly,” Saewyc says, “if half of trans men in this nationwide study of young people have attempted suicide in the past year, and those odds are even higher if they are bisexual, multi-ethnic, or live in rural areas or small towns, this is a serious concern. Communities should be working to ensure all our young people live free from discrimination and violence.”

Finch agrees. “I think one critical thing that both clinicians and the LGBTQ+ community as a whole need to do for trans men/trans masc folks is not to assume that ‘male privilege’ has shielded us from the devastating impact of patriarchy,” he says. “Even for those of us who have medically transitioned, we still bear the scars of what happened to us before transition.”

Finch also wants to remind everyone not to use these statistics to pit trans men against trans women.

“The reality is, access to privilege and power is very individual,” he says, “especially when someone is transgender. We are an incredibly diverse community.”

He further points out that this recent study doesn’t say trans men have it worse than everyone else, but that it’s a subject that both mental health professionals and the LGBTQ community needs to talk about.

“Data examining one population is not inherently saying something about another,” Finch continues, “and these are two distinct populations with complex challenges. In the end, this says more about patriarchy than it does about trans men or women.”

INTO’s roundup of our favorite new releases vows to remain purposefully intersectional in highlighting the best in queer music, both emerging and established. Because when things take a turn and you need a lift in spirits or just a distraction, music continues to serve as one of the most practical forms of self care.

Our queer musical intake in August was hearty and fortified. Haters will say it wasn’t the impact of Leo season. With their latest album, Resolution, self-released this month, Shamir brings us one of the most important rock songs of the year with “I Can’t Breathe,” in remembrance of the murders of Eric Garner and Tamir Rice. Yves Tumor continues to explore new sounds in their second track release this year, “Licking An Orchid,” paired with a haunting visual. Blood Orange released Negro Swan, narrated throughout by Janet Mock. Global popstar on the rise Rina Sawayama came out as pansexual this month in her song “Cherry,” referencing a girl gaze. Cherry emoji Twitter, rejoice.

Hayley Kiyoko won a VMA andshouted out queer women of color. Troye Sivan’s second album Bloom hit airwaves, and its pure pop ambient bliss portrays queer love in broad, defiant strokes. Pabllo Vittar snapped when she gave us a look at whatinflitrating Elon Musk’s estate might look like in a new video for her song, “Problema Seu,” complete with a Naruto-style shinobi-run at 1:48. Finally, Brooke Candy continues this recent trend of queer supergroup tracks enlisting Mykki Blanco, MNDR and Pussy Riot in “My Sex” which looks like really glossy imvu porn.

Listen and subscribe to our playlist of the best new releases in queer music below.

When I decided to write a PTSD Awareness Day piece to be published today, June 27, I hoped to speak to a dozen or more queer survivors of PTSD and complex PTSD from a range of backgrounds, who would — more or less — present a slice-of-life, if anecdotal, account of queer post-traumatic stress in mid-2018. I’m not a mental health practitioner, and I’m certainly not a researcher. Still, I’m in the business of storytelling, and, given how important telling and recontextualizing my own story has been to my own recovery process, I expected many others to be interested in sharing their stories with me.

I was wrong.

I don’t in any way mean to scold those who, for whatever reason, declined to participate or reneged their interest in participating once they learned the limited scope of my project. I see their decisions not to participate as self-loving and self-protective acts, for which I have tremendous respect. I’m grateful my own recovery has occurred on my body’s own timeline.

Rather, I’m sad for those of us whose access to judgment- and stigma-free care for post-traumatic stress is limited or nonexistent, despite the emerging modalities and treatments that can make life livable for so many of us. I’m sad for those of us who lack family, friends, or other supportive communities that could prop us up as we do the courageous and difficult work of making it through each day. I’m sad that so many of us don’t get to see into the messy, chaotic lives of others who are fighting the same battles and working to overcome the same barriers we are. I’m sad for those of us who believe our experiences aren’t important or valued. I’m sad that so many of us suffer in silence. I’m sad that so much of our suffering ends in premature, permanent silence.

But this isn’t just about me and my feelings.

I was able to speak to four individuals whose encounters with post-traumatic stress have validated mine and emboldened me to live the best life I can. I hope they do the same for you. I challenge you, specifically, to take on the mantle of deconstructing prejudice and stigma around mental illness — not just post-traumatic stress, but also post-traumatic stress; and not just for yourself, but also for yourself.

A word of warning: the accounts below describe emotional, physical, and/or sexual violence. Take care of yourself and opt out if you need to — and, anyway, the tl;dr is: Whatever you’re going through, you’re not alone, and you don’t have to suffer in silence.

Some names have been changed at the request of the interviewees.

Ariana

On Thursday, Ariana will be 29 years old. She was diagnosed at age 15, “so I’ve had it for almost half my life at this point,” she says. Her diagnosis came after a sexual assault. She’s been sexually assaulted twice, and her symptoms have been aggravated by abuse from romantic partners between those assaults.

“For a long time, I didn’t want to be around men — like, I would get really nervous and scared,” she continues, “so like, if it was on an elevator and it was by myself, I would avoid men entirely.” Ariana has a long history of nightmares that end in cold sweats. They continue to this day. “I get really jumpy. I get startled really easily. And if there was anything similar, like, if I was experiencing any kind of bad behavior from other people, then I would get upset again and I’d have the symptoms recur. I also have really bad anxiety.”

Ariana, a queer woman of color, spent the eight months leading up to March of this year living in the New York City shelter system. A physical disability, the result of a pulmonary embolism, poses challenges for her work and social life, but Medicaid covers transportation by car to her therapy appointments, and her college’s accessibility office provides accommodations around her education.

However, access to other resources is less readily available. She’s been trying to find a support group for survivors of sexual assault, but resources are scant. She also finds that, as she gets older, her access to care becomes harder to find, because care providers want to send her to queer-only — as opposed to general-population — facilities. It’s easier for Ariana to open up to others in the evening, so she prefers evening therapy appointments, which are hard to come by. Having been seen, for most of her life, by white practitioners, she prefers to work with those who are people of color — after 20 years in therapy, she’s currently working with a person of color for the first time.

After becoming disabled in 2011, Ariana began drinking and using drugs more heavily. She went to AA for 18 months, but ultimately found that, rather than being an alcoholic, she simply used alcohol to cope through a very difficult time in her life. She sees 12-Step programs as only one method of working towards sobriety. Queer people, she says, face judgment and heteronormative cultural practices they find alienating. Though the friends she made in AA abandoned her after she left the program, she maintains friendly contact with her former sponsor.

She’s worked with EMDR (eye movement desensitization and reprocessing), and has found it helpful; she’d like to come back to it. In the meantime, she is hopeful about a DBT (dialectical behavioral therapy) group she’ll be starting soon, which works to address both her PTSD and BPD (borderline personality disorder) symptoms. She’s also found art therapy and adult coloring books to be effective.

“I feel like group therapy is tricky,” she says, “because if you don’t have a group of people that you’re comfortable with, it can turn the whole experience sour.” Ariana says that, for group therapy to be effective, there has to be a common respect for experiences of difference and a willingness to listen to everybody.

“I’ve been through a lot,” she responds, when asked how her relationship with trauma has changed over the last few years. “Like, last year, I was homeless, and I was living in a shelter… it’s definitely something ongoing. I haven’t gotten to a point where I’m like, ‘Yeah, I’m totally over this.’ I don’t know if that exists, or you just get to a point where you’re, like, ‘Okay, I can deal with this better than I could before,’ you know? One of my closest friends, he’s got the complex PTSD and he’s 31 and still processing. So it’s like… it depends. I don’t know. For me, I don’t know if it’s ever going to go away; I just think it’ll get easier for me to deal with.”

As far as how she’s doing now, she says, “I wouldn’t say I’m happy all the time, because no one’s happy all the time, but I just feel like, overall, I’m more content with who I am as a person, now, than I was a few years ago. I’m able to deal with things in a more healthy way.”

She says that talking about what happened to her is helpful: “It relieves some of the burden. It may not take away the pain, but I think you just feel a little bit lighter.”

Katrina

Katrina doesn’t have a PTSD diagnosis — her therapist doesn’t like to talk about diagnoses out of a concern for labeling her. She hadn’t heard about complex PTSD, or C-PTSD, until she saw my call for stories. After doing some research, she feels that a C-PTSD diagnosis, and the treatments it may open up for her, could help her to process some of her early life experiences.

Katrina is a 50-year-old lesbian who grew up with artistic talent and high hopes for her artistic career. Recently, though, she finds it difficult to do even the things she loves to do. “I’m not enjoying my life,” she says. “I’m not doing the things that make me happy. I have some kind of fear of success. I’m not sure what it is, but I’m blocked, just completely blocked, in a way that shifted in my adolescence. I feel like I lost my life, and I’m trying to claim myself back and be that person who… I was very sure of myself as a kid, and, just… things happened.”

She was hospitalized in a psychiatric hospital at 16, but 34 years later, she feels like she’s still there. “They put me there because they didn’t know what else to do with me,” she says. “I just wanted to get away from my family. It was a very, very destructive place, certainly an awful place to be. But it had long-range consequences, because they convinced my parents that I wouldn’t graduate from high school, that I had all kinds of psychiatric deficits. I’m not sure what they happened. They just… the constant pathologizing of me, it just beat me down.” She was diagnosed with bipolar disorder and borderline personality disorder, but a PTSD diagnosis didn’t enter her awareness as a possibility until recently.

Her hospitalization came in response to an episode of traumatic grief after losing her grandmother, the closest person to her. Katrina’s parents ignored, neglected, and emotionally abused her throughout childhood, but her grandmother was always there for her. “So when she was gone,” she says, “there was nothing… I had no one on my side.”

Like Ariana, Katrina has nightmares, but she also relives her traumatic experiences through flashbacks and is subject to retraumatization. Her nightmares are recurring, and they involve being locked up in the psychiatric hospital and being mistreated as a psychiatric patient. “I was not ill,” she says of herself when she was hospitalized. “The treatment — I’m sure wasn’t meant to be cruel — made me ill.” When she has to go to hospitals today, she freezes, feels helpless, and experiences a feeling “of being a child, and needing something, and it not being there, and I’m going to die, and no one cares.” When her mother died, she witnessed her mother’s death over and over again — two to three times a night — in her nightmares. Those nightmares persisted for over a year.

Katrina tried to communicate to her parents, in childhood, that she had an eating disorder, but they refused to listen: “They said I just wanted attention and ignored me.” Her eating disorder went untreated until after graduate school. “I had a childhood in which my reality was constantly denied by my parents and it made it so that I didn’t feel like I could trust myself,” she adds.

She really likes her current therapist, who she’s been seeing for five years. She even has a huge crush on her. “I thought that that connection, since I don’t feel that connection very often,” she says, “would push me more than I’ve been able to push myself with other therapists. Even if I was doing it for her, which didn’t turn out to be the case, at least it would push me toward health.” Her one complaint: “I wish she would work with me more on exploring things,” she says. “She only lets me talk. She doesn’t want to see anything creative, which is how I access my feelings — you know, they don’t come to me when I’m speaking.”

Katrina first was exposed to literature on trauma in graduate school, when one of her advisors recommended Judith Herman’s Trauma and Recovery. Even the little bit of research Katrina has done on C-PTSD has been helpful for her. “You know, in reading this stuff, with the traumatic grief and complicated mourning,” she says, “it helps me to wrap my mind around what happened to me so I can just… you know, sometimes, if you can put something into a sentence and put a period at the end, or a question mark, or whatever you need, and just express it, it helps to clear the path for you to create another sentence.”

With regard to her relationship with her trauma over time, Katrina says, “It gets better as I get older.”

Ralph

Ralph, a 28-year-old white gay man, moved to New York two years ago for graduate school. “I grew up in this Southern culture,” he says. “I didn’t grow up, necessarily, in the church, but definitely the kind of culture that places respecting your family and having this false sense of obligation to blood members of your family being the end-all, be-all kind of attitude.”

His mother was 16 and ill-equipped to take care of him when he was born, so he was raised by his paternal grandmother. He and his mother didn’t bond growing up, and they no longer speak. “I spent most of my childhood with her on weekends and different things,” he says, “but it really wasn’t, honestly, until I was an adult, and I came out, and I started to have a little bit more self-reflection in college, and then, it fully wasn’t until after I’d separated her from my life, that I started really evaluating the not-okay interactions with her.”

The hallmark of Ralph’s mother’s abuse was to create situations in which Ralph was dependent on her, then shame him for his dependence. “She would hand you a gift then punch you in the face, metaphorically,” he says, “and then be angry that you didn’t thank her for the gift after she punched you in the face. It was a lot of psychological torture.”

After college, Ralph’s mother offered to buy his car from him so that he wouldn’t have to keep making payments on it, then changed the arrangement right before he was about to leave for New York, asking him to cosign a sketchy loan with her new beau instead. When he pushed back, the conversation escalated. She physically attacked him and began to destroy his things, at which point he called the police. When the police arrived, she misrepresented the story to them. “I had a window of opportunity of finally being able to stand on my own two feet without needing anyone else in starting my own life in New York,” he says. “And that wasn’t comfortable for her, because she wanted to have power and wanted to have control by any means.” When I spoke to Ralph, it had been exactly two years since he cut off contact with his mother.

But the effects of her abusive manipulation haunt him to this day. “Any time I had ever achieved any kind of accomplishment or had something great to look forward to or, just, anything good that was like happening in my life,” he continues, “she would always find a way to insert herself and create chaos and disruption and trauma. And I realized that as graduation [from graduate school in May] drew near, it really didn’t feel like an accomplishment for me. I had a sense and a feeling of terror and impending doom.”

He also finds it difficult to socialize, accept friendships, and ask for help when he needs it. In graduate school, he found it difficult to work in the noisy lobby of his department, and became aggressive and angry at fellow students when it became too much. When his doctor asked why he felt he should be able to work in the noise, he said, “because I feel like I should be able to do anything and not be completely crippled and angry when there is noise around me.” He also has recurring depression and anxiety.

As an artist, he’s had to reckon with the cultural notion that artistry requires abstinence from psychiatric medication, but went on an SSRI (selective serotonin reuptake inhibitor) while in graduate school. The medication made him feel like a zombie. When he asked to go off the medication, his doctor put him on a 10-day tapering protocol. “That was way too fast,” he says. “And then I had a complete breakdown and I had very terrible withdrawals where my body was, like, complete electric shock.”

Ralph had access to counseling while in undergrad, which he says saved his life, but he isn’t currently in therapy. “To me, the way that I’ve actively tried to combat [the effects of trauma on my life] is to practice gratitude and generosity,” he says. “Any time where I felt like I’ve been overwhelmed, I’ve just tried to constantly reach out and verbalize and affirm my thanks for people that have even done small acts of kindness for me. Or actively trying to acknowledge and verbalize when I see someone doing something that I think is amazing.”

He still experiences fear that he won’t be able to manage, but he’s aware of his resilience. “I haven’t ever been in a situation where I couldn’t figure out my way around it,” he says. “And I think, the longer that that has been true, and the more that I have navigated through that… even though things are stressful, and I feel scared, and things are not easy, you do kind of develop a competence to keep moving forward.”

Jeffrey Anthony

Jeffrey Anthony is a certified health education specialist with a background in public health and health education. His focus is in human sexuality, and he works with gay male, queer, and HIV-positive populations. He currently works for a sexual violence program where he does crisis counseling, grant-writing, and educational material design. His clients have lived through sexual violence and often have intellectual and/or developmental disabilities. He is a white, cisgender, queer gay man, and he suffers from PTSD, C-PTSD, bipolar depression, generalized anxiety disorder, and was recently diagnosed with high-level autism (ASD Level 1).

“I will tell you that my one thing that I do appreciate about the trauma is it gives me a sense of humor,” he says. “And I actually think that is a common theme in a lot of people that have experienced trauma is a dark, morose, and absolutely beautiful sense of humor.” But there’s plenty Jeffrey doesn’t love about his trauma.

“PTSD stands for post-traumatic stress disorder,” he continues. “And the main difference is one is an acute trauma, and the other one is an ongoing trauma. Now, I’ve been diagnosed with PTSD, and I’ve been diagnosed with complex PTSD. So I am a survivor of sexual violence, twice in my life — one being far more a physical assault and rape than the other one, which was molestation. And there was sex and grooming and things, but it filled other emotional needs. And so none of these things happened in a vacuum, and that kind of builds on each other. But the other thing that I come from is a family that was emotionally and physically abusive. And so that continued — ongoing belittlement and physical abuse throughout my early childhood and into my teenage years. I’m 32 now, and occasionally my father still tries to make a snip at me. And now, I’m like, ‘Old man, I will break your arm.’ But it’s that ongoing abuse that led to that complex PTSD: that constant trauma, that ongoing, chronic trauma. That’s the difference.”

Jeffrey’s parents sought out diagnoses for him throughout childhood — he believes it was a way for them to feel better about their mistreatment of him. “My parents brought their bullshit with them and took it out on me,” he says. “And so I became their punching bag. And so that’s kind of the impetus for the development of my complex PTSD.”

His recent autism diagnosis sheds light on a childhood he’d previously misunderstood — he now sees a connection between his symptoms and the way fights escalated at home. Though his symptoms weren’t his fault, he internalized the blame. “I identified my parents as people that were supposed to protect me,” he reflects. “But why weren’t they protecting me? Is it because they were flawed humans? Or because I was a terrible person?” Jeffrey was physically abused by his parents as early as first grade, if not earlier. “It [was] far easier, and less terrifying, for me to identify myself as a bad person than the people I trust.”

“So it is this ongoing relationship where it manifests another way, where people say, ‘Oh, you’re still hearing your father talk to you like you were a child,’” he continues. “That’s kind of what [complex] PTSD is: that little voice from your childhood that’s having things just come back, and kind of flashback, versus an acute thing where, you know, fireworks go off and someone’s a wartime vet, and the fireworks sound like a shell going off, and they suddenly flashback to wartime. Very similar mechanisms, but it happens in very different ways. And so the complex PTSD then also starts to develop anxiety, because the coping mechanism, then, is, ‘I have to worry how am I going to survive. What would my survival skills? What I need to do?’ I’m a very charming person because I was afraid that I was going to be killed by my parents, specifically, my father. So I’m very good at getting people to like me, and for that reason, I also don’t trust when people like me and genuinely seem to like me.”

While the ongoing abuse at home led him to develop C-PTSD, the sexual assaults he endured were acute and led to his PTSD diagnosis. “When I was in high school, I was sexually assaulted,” he says. “They physically knocked me unconscious. They tied me down and then they raped me. And so that built some trust issues. I very much can’t handle bondage or the idea of being restrained — it makes me very claustrophobic. And I can’t handle certain things. It also was a person that I trusted, and so it built into other trust issues that already existed. I had an ongoing sexual experience, when I was 12, with someone who lived in the neighborhood, that was, give or take, 18. And at the time, I was very aware of what I was doing — probably that I shouldn’t have been doing it — but that this person made me feel special and wanted. And so, to that end, that continued, in some ways. And I look back on that and, you know… there’s a chance that that never would have happened, had I had a family that was more supportive, and gave me the attention that I desired, because I know that there was part of me that actively sought out that attention.”

Jeffrey has a long history of bad treatment from unqualified mental health care practitioners, one of whom used their sessions as an opportunity to vent about his divorce. “The concept of trauma-informed care is a relatively new concept,” he says. “And I think a lot of that is ego, on the part of practitioners, not recognizing that Sigmund Freud is an asshole and doesn’t actually know what he’s talking about and doesn’t contribute much to the field of psychology. Doctors kind of want this prestige of, ‘Oh, I’ve fixed you,’ and you don’t do that with mental health. There is no ‘fixing,’ really. There’s healing, and there’s scarring, but ‘fixing’ is not the word anyone will use.”

“The other part of it is,” he continues, “because individuals experiencing mental health issues are so disempowered, it creates an unfortunate power dynamic that exists where psychologists, therapists, what have you, won’t do the work to empower you, just… what is the way to make them feel like you’ve made progress?”

What ways can people suffering from trauma do to empower themselves? “I don’t know that I’ll tell anyone that they don’t need to be saved,” he says. “What I would tell them is that, if you think you need to be saved, unfortunately, you’re the person who has to save yourself. No one else can do that for you.”

“One of the ways to empower people is to let them feel the way they want to feel,” he continues. “Give yourself permission to feel. It’s okay to feel what you’re feeling. You can learn to understand why you’re feeling it. That’s the way to heal. I don’t need to be fixed. I need to heal and I need to grow. And it’s it’s about shifting that mindset of ‘Oh, I’m broken. Oh, I’ve got baggage.’ We all have fucking baggage. No one’s shit smells like roses. Even if you take the damn pills to make it [smell like roses], it’s still shit that smells like roses. It’s still shit. We all have it. And acknowledging that — in the very holistic way that I am —we’re all going to fucking die anyway, so what does it matter? But also, at the same time, that doesn’t mean I can’t have the best life that I want to have.”

While he’s aware of the loaded language behind terms like “victim” and “survivor,” he does hope to point those who suffer with trauma to a mindset of having survived. “The idea of being a survivor is that you acknowledge it is an ongoing thing. I have complex PTSD. I relive a lot of trauma all the time. I left work two hours early today because I had an anxiety attack so bad I threw up and I was having hot flashes and I couldn’t work. And I don’t always function. Where I have the choice, and it’s not an easy choice, is to do what I need to do to take care of myself so I can get to a sense of peace, and, perhaps, happiness. I don’t know that happiness needs to be the goal. I don’t know that I will ever be a happy person. I have moments of joy. But the choice is, I could stay at work and continue to be miserable, or I can go home and take care of myself and get a little bit better by taking care of myself and prioritizing that. That is the choice.”

“And I would say, even if you don’t think you’re worthy yourself, there are people that will always stick with you,” he continues. “Try and remember that that means you’re worthy. Find other ways to support yourself, with people that will say, ‘It’s okay to feel that way. I can support you without actually taking on your burden because you’re not a burden to me.’”